Choline on the Brain? A Guide to Choline in Chronic Fatigue Syndromehttp://phoenixrising.me/research-2/the-brain-in-chronic-fatigue-syndrome-mecfs/choline-on-the-brain-a-guide-to-choline-in-chronic-fatigue-syndrome-by-cort-johnson-aug-2005
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Chest Pain

Creekfeet I also get a great deal of chest pains these days usually coupled with a bout of orthostatic intolerance and some degree of shortness of breath. While I think it needs to be checked out, I don't want to because my family doctor will brush it off and emergency doctors will laugh at me :ashamed:
Of note I have had a holter monitor and echo last year and it appeared all normal. Maybe they were not the right tests?

Dr Lerner and Dr Cheney are well aware of the type of heart problem a CFS patients can have. It is not related to blocked coronary. It is usually diastolic, mitochondria, and low blood volume related. It would need a really astute cardiologist to figure it all out. And then I would be worried to bring a scientific paper to the emergency... It would sounds rather hysterical???

When I had bubble injection with the echogram it showed abnormalities. The doctor also suggested to keep trac of the heart iregularites and bring them in to the cardiologist- - i just use the bp cuff and write down the bp - rate - and time or situation, and standing, sitting etc. The cfs doc here says with some that it is virus attacking the heart and he prescribes immunovir - he does say it is only confirmed in autopsies though I kind of get it in spells so kind of makes sense that it is virus attacking heart, then it goes away, but who knows

Thanks, all! I'm continuing to slowly study the heart aspect, along with other aspect of this amazing complex condition. It's a tremendous help and comfort to have all of your input.

There's been a hold-up in getting my records transferred from my previous doctors, and this in turn appears to be holding up my primary physician's progress in evaluating my condition and referring me to a cardiologist. Meantime, the gyn wants an endometrial biopsy and that's taken precedence as the first thing to clear out of the way. I'm hoping to restart the paperwork to get those records transferred and get the whole Rube Goldberg machine of documents and referrals moving again towards cardiac care, when I'm up at the hospital and clinic Thursday for that biopsy. Will I get referred to a good cardiologist who knows how to interpret symptoms in ME/CFS? Will I get referred to any cardiologist at all? Stay tuned.

Hi creekfeet. I get heart pain as well. It's a crushing angina type pain and it is at its worst when I am exerting myself and trying to fill my lungs. It also occurs every now and again in a more subtle way, usually when I am stressed. I can't say what causes your pain or mine but here is something of interest.

Have a look at the following piece of research.

The symptoms of Chronic Fatigue Syndrome are related to abnormal ion channel function

It explains that chest pain is a common symptom of both CFS and Cardiac Syndrome X. The authors did cardiac thallium SPECT scans on CFS patients and found that they had hypoperfusion of the heart, which is also a finding in Cardiac Syndrome X. Their conclusion (based on other findings and observations as well) is that a channelopathy is causing the perfusion defect which causes an angina-type pain.

I get all kinds of heart stuff from this. And I showed up on a test as having a problem with the left ventricle of my heart. Then I had the test done again recently and they either misread it or I don't know what cause now they're like, you don't have it. But I still have the pain. I get pain, I get irregular heartbeats, I get like a weird thing where it's like a jolt through me of a missed heartbeat or something. The last two docs I saw about it were clueless and said it must be just the fibromyalgia, yeah right. I'm pretty much convinced I will die from the heart thing within the next ten or twenty years.

Scanning this thread it seems much of the heart conditions commonly described for PwME/CFS have been mentioned.

On a hopefully non-heart condition possibility, many also have fibromyalgia, and a separate but related condition of chronic myofascial pain. The tissue dysfunction of adhesions and myofascial trigger points (TrPs) can cause the described chest pain (and is different than costochondritis).

"When you have TrPs, muscle strength becomes unreliable. Your grip can fail. TrPs cause muscle weakness and dysfunction before they cause pain. You may have also noticed that if one part of your body rests over another, the compressed part goes numb. TrPs can cause restrictions to blood vessels, lymph vessels and nerves. Remember that these structures pass through the fascia. Other associated symptoms may include stiffness, muscle tightness, localized sweating, tearing, salivation, poor balance, irregular heart beat, dizziness, pelvic pain, diarrhea, impotence, nausea, tinnitus, goose bumps, runny nose, buckling knees, weak ankles, illegible handwriting, headaches and muscle cramps. A new way of imaging soft tissue elasticity has been mentioned in a Mayo Clinic press release as a potential method to locate many myofascial trigger points."
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Chest pain diagnosed as angina, heart pain, pleurisy, and costochondritis (inflammation of the ribs) may actually be referred pain from myofascial trigger points (tiny contraction knots) in strained or overworked pectoral muscles of the chest. Pain from these trigger points can also lead to the supposition that you have a separated rib, an ulcer, or gallbladder trouble.
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These are some of the surprising discoveries by Doctors Janet Travell and David Simons, revealed in their widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual. The trigger points shown here in the pectoralis major muscle can cause pain that feels like angina from the heart.
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"Chronic myofascial pain can mimic or accompany cardiovascular disease (Simons, Travell and Simons 1999). You need to be familiar with the myofascial trigger points (TrPs). Both FMS and CMP work together to create a symptom load greater than the sum of the two and may present a picture perplexing to the diagnostician."​

Devin learned about trigger point from the work by doctors Janet G. Travell, MD and David G. Simons, MD

A myofascial trigger point is a localized area starving for oxygen. It creates an increased local energy demand. This local energy crisis releases neuroreactive biochemicals which sensitize nearby nerves. The sensitized nerves initiate the motor, sensory, and autonomic effects of myofascial trigger points by acting on the central nervous system. Muscles with trigger points are muscles in a constant state of energy crisis.

Myofascial trigger points can be identified and documented electrophysiologically by characteristic spontaneous electrical activity (SEA). They may also be identified histologically (which means that the structure of the cells have changed) by contraction knots — the lumps and bumps we know only too well. Both of these phenomenon seem to result from excessive release of the neurotransmitter acetylcholine (ACh) from the nerve terminal of the motor endplate (the complex end formation of the nerve).

We now have objective confirmation of electromyographic imaging of a myofascial trigger point. There is also ultrasound imaging of local twitch responses of trigger points, and biopsies of myofascial trigger points that show contraction knots and giant rounded muscle fibers. To quote from this article, "The endplate dysfunction characteristic of MTrPs involves both the nerve terminal and the postjunctional muscle fiber. This relationship identifies MTrPs as a neuromuscular disease." Simons DG. 1999. Diagnostic criteria of myofascial pain caused by trigger points. J Musculoskeletal Pain 7(1-2):111-120.

A MTrP is always found in a taut band which is histologically related to contraction knots caused by excessive release of ACh in an abnormal endplate. The pathogenesis of myofascial trigger points appears to involve serious disturbance of the nerve ending and contractile mechanism at multiple dysfunctional endplates. Doctor Hong has even formed a theory concerning fibromyalgia tender points. Hong, C-Z. 1999. Current research on myofascial trigger points-pathophysiological studies. J Musculoskeletal Pain 7(1-2):121-129.
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The day I became so ill was after walking a few miles in 93. I had noticed my chest felt tight and it was hard to breath as I walked along. There was also a tired feeling. A spasm went across my chest that almost knocked me to the floor when I reached home. I thought heart and then felt very sick and ran to the bathroom. It was the flu from hell and chosto was part of it. It happened exactly 2 weeks after the flu shot of 93. I was sick 8 years and then slowly climbed out of the hole and up to 80-90%. I crashed after 8 good years last April and you guessed it. It started with the rib cage pain again. I find that heat helps and sometimes ice. I can't take any of the usual drugs to calm down the inflammation.

chest pain can also be from different types of orthostatic intolerance (POTS/NMH)

I don't have a direct link handy (might be on this web site somewhere - http://www.dinet.org/) but I have read that chest pain can also be a symptom of various forms of orthostatic intolerance (e.g., NMH or POTS).

I've had chest pains for 20 years but I never figured out what causes them. Like almost all of my symptoms they get worse with exertion and better with rest. After a couple of initial screening tests (EKGs and echocardiogram) I have completely ignored them since 1) heart disease does not run in my family, 2) all my heart disease indicators are great (very low cholesterol, etc.) and 3) my chest pains are the least of my problems.

It just goes to show you how jaded I have gotten from dealing this ME/CFS symptoms (not that I'd necessarily recommend this attitude). Chest pains? Meh. It's just a few sharp pains that come and go every couple of days, and sometimes even go under my arm, but which can be easily ignored. Twenty years and no heart attack so I'm pretty sure my own chest pains are not from angina/clogged arteries. But every patient is different.